July 2014 – March 2019 Emotional Wellbeing and Mental Health: Everybody’s Business DRAFT STRATEGY FOR CONSULTATION

Foreword When the Surrey Health & Wellbeing Board was established we selected our priorities based on what we could do better together that would benefit all. What this means is that no matter in which field or area we work, be it health, social care, education, housing, the economy, or elsewhere, our actions should be intertwined. Positive mental health is a foundation of individual and community wellbeing. The communities in which we live, the local economy and the environment all impact on an individual’s mental health. That is why this Board has made improving emotional wellbeing and mental health a priority in our strategy to benefit the people and communities of Surrey and North East Hampshire. This strategy sends a clear message that the delivery of the improvements we want to see can only be achieved by concerted effort and commitment on behalf of all Health and Wellbeing Board organisations and our partners. This may be by improving mental health awareness in the workplace, recognising the impact of stable accommodation or acknowledging the importance of sports and culture to our individual and collective emotional wellbeing and mental health. This is why, on behalf of the Health and Wellbeing Board, we are pleased to offer our support and commitment to this strategy. We will place it at the heart of commissioning and provider development and expect all of those who work with us to do likewise. Michael Gosling & Dr Andrew Whitfield

Introduction disability in the UK This is a strategy for Emotional Wellbeing and Adult Mental Health for the Surrey and North East Hampshire population of approximately 1.4 million people. The document contains our strategy for mental health promotion and the commissioning of mental health services for adults of working age. It will reference, but will not be covering, children’s, substance misuse, learning disabilities, autism and older adult mental health and dementia which currently have their own strategies.

Our vision Mental Health is as important as physical health. In Surrey and North East Hampshire we will transform lives by making mental health everybody’s business with parity of esteem to physical health. We will work together to build a place that people feel proud and safe to live and where all people with mental health problems, their families and carers needs and basic rights are met, recognized and respected.

Good mental health holds the key to a better quality of life. We need to promote positive mental health, prevent mental ill health and intervene early when people become unwell. Promotion, Prevention, Early Intervention Mental wellbeing is everybody’s business. It affects every individual and impacts greatly on our society. It can only be improved if there is collective responsibility, a scaling up of integration and assertive action taken at all levels across agencies. Working Better Together Building a strong partnership between commissioners, patients, carers and their families encouraging an equal role in shaping the support available Service User and Carer Partnerships Effective Crisis CareMaking Recovery Real 5 Principles of Transformation People should get as much support to prevent and deal with a crisis from a mental health problem as they expect to receive from physical healthcare services. People should receive recovery focused support that offers hope, fulfillment of potential and to live their lives on their own terms

Commissioning context - need Mortality rates for people with a severe mental illness are three times higher than in the general population Incapacity benefit claimants: England Av 42% Surrey Av 46% Incapacity benefit claimants: England Av 42% Surrey Av 46%

Commissioning context – services, spend and performance

You said: we will do An evidence base and co- production has been at the heart of the strategy development. People asked us for a focussed approach that would deliver on key areas. Priorities for people are to shift the culture of services that feel inflexible to a culture where services work together and wrap around the individual, their family and carers; and to place the priority on preventing illness & promoting wellbeing for all.

Priority 1: Prevention, promotion and early intervention Outcomes to achieve – More people will have good mental health, Better physical health, Fewer people will suffer avoidable harm and Fewer people experience stigma and discrimination Actions: In year 1: Expand roll out of local “Time to Change” Promote and signpost to the relationship, benefit and debt advice services Promote self help and management Lifestyle targeted campaign Monitoring of health risk factors Annual health checks are completed and acted on In years 2 and 3: Implement Five Ways to Well-being campaign Deliver resilience programmes Develop referral support to GPs Awareness raising of link between long term conditions and depression and signpost to resources and services Develop a specialist peri-natal service to support mainstream services In years 4 and 5: CCG’s, health providers, SCC and District and Boroughs to attain mentally healthy and wellbeing employers status

Priority 2: Working better together Outcomes to achieve – Better physical health, Fewer people will suffer avoidable harm and Fewer people experience stigma and discrimination Actions: In year 1: Develop protocols to guide and support transitions and standards between services Ensure parity of esteem for mental health is articulated in strategic and commissioning plans of organisations Develop a mental health provider forum in order for connections to grow In years 2 and 3: Develop joint commissioning for voluntary sector and Section 117 Quality data will be available and transparent on performance of services and commissioning spend Information on mental health service pathways will be available and accessible to other services Partner agencies will be expected to jointly plan and provide integrated services and environments to meet the needs of those with mental health problems Wider workforce training on mental health and suicide awareness In years 4 and 5: Commissioners and providers will review care pathways and specifications with service user and carers to ensure they are seamless across services, meet the specific needs of all age groups and are integrated to more effectively meet the complete needs of people with co-occuring problems Education programmes will be delivered to GPs on common mental health problems

Priority 3: Partnerships with service user and carers Outcomes to achieve – Positive experience of care and support and Fewer people experience stigma and discrimination Actions: In year 1 : The Independent Service User and Carer Group and Local Stakeholder Forums will be formalised within the mental health governance structure and terms of reference for the working arrangements refreshed All service users and carers will be involved in their care planning and be given choices they are entitled to Carers wellbeing will be recognised and the numbers of carers being offered assessment and entered on GP carers registers increased Increased Services will ensure that carers can gain access to their own needs assessment within a primary care, generic or mental health setting and their role valued in the creation of care plans Service user and carer feedback and involvement in delivering services is mandated In years 2 and 3: Training will be developed and provided to service users and carers to support and strengthen their role in commissioning of mental health services covering service redesign, influencing skills and service outcome monitoring Representation for carers in commissioning is supported to represent mental health issues adequately Accessible information will be made available to service users and carers to make an informed decision on their care In years 4 and 5: Work in partnership with service users and carers on their ideas for different approaches to widen involvement such as service user led website, carers on-line forums

Priority 4: Effective crisis care Outcomes to achieve – Fewer people will suffer avoidable harm and Fewer people experience stigma and discrimination and Positive experience of care and support Actions: In year 1: All key agencies have signed up to the Surrey Mental Health Crisis Concordat declaration and committed to deliver an integrated emergency response Review the right level of beds and crisis model for safe quality services through simulation modelling and what impact a shift of resource would create enabling a redirection of resource to fund services to provide Crisis Care Establish local solutions and partnerships to better meet the mental health crisis needs of communities Establish co-location, information sharing and integration opportunities for mental health within the public access services (111/999) as a first step to the 24/7 single point of access In years 2 and 3 Establish the 24 hour 7 day single point of access for mental health crisis across Surrey and NE Hampshire with a response service pathway developed Enhanced 24/7 Home Treatment Teams delivering a higher volume of service to people in their own homes Voluntary Sector Led Local Crisis Services and peer support schemes are increased All people in specialist mental health will have a crisis contingency plan that has been developed with them and their carer Agreed protocols between emergency services for mental health crisis care have been implemented across Surrey and NE Hampshire Ensure psychiatric liaison services are sustainable through the Better Care Fund work

Priority 5: Making recovery real Outcomes to achieve – More people will recover and have positive experience of care and support Actions: In year 1 Comprehensive care plans will be the norm for people with mental health problems with the option to consider direct payments, be advised by people with expertise in employment, benefits and housing as well as treatment and care, and a focus on achieving their personal goals for recovery (WRAP) We will work with partners to fully explore the opportunities offered by new technology in relation to mental health service delivery Development of volunteer and peer support schemes for people who use services and carers In years 2 and 3 General Mental Health Recovery services and MH voluntary sector services will be integrated into primary health care integrated hubs to enhance choice and facilitate wrap around services with one single point of access to all hub services We will maximise opportunities for social housing for people with MH problems and work with partners to ensure enough appropriate accommodation is available Shared care and enhanced service schemes to be developed between primary and secondary specialist care to support primary care increased role in supporting people in their recovery Reduce the use of locked rehabilitation and out of area residential care In years 4 and 5 Develop integrated programs between mental health support services and housing agencies to provide tailored assistance to people with mental illness and mental health problems living in the community.

Who will help us succeed

How we will know we are succeeding

What we need to know from you 5 ways to give us your views on our strategy 1. Completing the questions via our on-line survey 2. Invite us to one of your meetings to discuss your views: us at: 4. Contact us by phone: Write to us Mental Health Strategy Consultation North East Hampshire & Farnham CCG Aldershot Centre for Health Hospital Hill Aldershot GU11 1AY 12 week consultation: 14 th July 2014 to 6 th October Questions Do you agree with the priorities identified in the draft strategy? Do you agree with the actions identified? Are there actions that we have missed that you want to tell us about? Any further comment you wish to make about the draft strategy? If you require this document in an alternative format or a freepost address please telephone or us.